Codes and Frequencies
For sample adults and sample children who currently have health insurance coverage through Medicaid, MCAIDXCHG reports if the person's Medicaid was obtained through a state or federal insurance marketplace (e.g. Healthcare.gov or a state Health Insurance Marketplace). Prior to 2019, this variable was available for all persons with Medicaid coverage.
New questions were added to the Health Insurance section of the NHIS Family core in 2014 to obtain details about whether plans (both private and public) were obtained through Healthcare.gov or the person's state Health Insurance Marketplace, whether there is an enrollment fee or premium (public plans only), and whether the premium is based on income (expanded to include public plans).
This follow-up information is now collected for all types of private and public plans and is intended to help correctly classify plans that may have come through the Federal Health Insurance Marketplace or state-based exchanges. This acknowledges that some respondents perceive exchange coverage as a public program and others perceive exchange coverage as private health insurance.
For persons who were reported to be covered by public plans, respondents were asked if they obtained this coverage through Healthcare.gov, the Health Insurance Marketplace, or the name of their state's exchange. In general, if a person was reported to have obtained insurance through an Exchange (or to have obtained insurance elsewhere), the reported coverage is taken to be accurate unless some other information clearly contradicts that finding (e.g. a person with a private plan whose plan name does not match those offered through the person's Marketplace).
This was followed by a question that asked if there was a premium or enrollment fee associated with the plan (e.g. MCAIDPREM). If this was the case, the respondents were asked if this premium was based on income (e.g. MCAIDPINC).
Persons included in the universe are persons who were classified as having Medicaid in the back-edited variable HIMCAIDE. This is recommended as the most reliable source of information about the type of insurance coverage compared to that provided by respondents' original unedited answers about their insurance type.
MCAIDXCHG is completely comparable before 2019.
The NHIS questionnaire was substantially redesigned in 2019 to introduce a different data collection structure and new content. For more information on changes in terminology, universes, and data collection methods beginning in 2019, please see the user note.
2014-2018: All persons with Medicaid coverage.
2019-2022: Sample adults age 18+ and sample children age 0-17 with Medicaid coverage.